Today I was looking back at my last four weeks of BG values. My average was 138.I noticed what seemed like a pattern: most of my peaks fell on a Monday (or a day after a holiday, like July 4th), as if there was a "buildup" throughout the weekend or the holiday… does that make any sense?
Manny: Do you eat, or indulge, more during the weekends and holidays? I have talked to others that do.
Here is my chart for the last 30 days. I am supposed to keep my blood sugar between 80 to 120. I was waking up with some lows (below 70). I stopped taking one medication that was helping me to produce more insulin. My morning readings then went back up into range.
I’m curious why you are graphing “daily averages” rather than actual values. My daily averages based on the meter averages (fasting and after meals) are much prettier than my actual readings because of the amplitude of the swings.
Unfortunately for me, my A1c is more reflective of the highs I get after meals than it is of the meter average.
I went off metformin this week because I was having some stomach problems and in the past going off met for a few weeks has always restored my stomach to happiness. But all my beautifully worked out insulin dosing is out the window and because I am very sensitive to insulin I’m working up to the new dose 1/2 unit at a time which has given me a couple days of much too much time spent over 140 mg/dl.
Right now I’ve gotten up to 5u per meal instead of the 2.5-3u I use with the Met, but I’m still staying a bit high after meals.
I often wonder if Met might actually help Type 1s get better control. It sure makes it a lot easier for me to use insulin than without, though even without met my insulin sensitivity is still pretty strong–5 units for 40 gm of carbs is not a typical Insulin Resistant Type 2 dose. But it is so much easier to avoid highs and lows when I’m taking the met. I think that is because it shuts down the liver’s production of glucose, or something like that.
My doctor is having me test my blood sugar only before breakfast and supper (or dinner). Why not more may be due to insurance.
Why not more might be because your doctor is using an old fashioned, outdated method of testing blood sugar that only makes sense if you are injecting insulin. I bet he learned it in school 25 years ago and hasn’t kept up.
The usefulness of testing for a type 2 is to see what your meals are doing to your blood sugar. We know now that spikes are what does the most damage, so unless you know how high you are going, you have no idea how controlled you are.
Also, if you test after a meal, you can see the level of carbs that is too much for you, and cut back on the carbs in the meal until you are not going up to a dangerous level.
LImited strips means you have to select the meals you commonly eat and test them one at a time until you can adjust the carb load to give you healthy blood sugars.
I have a horrible feeling, though, that your doctor will tell you that a blood sugar of 180 mg/dl 2 hours after eating is “great.” Also way outdated.
The organization of Endocrinologists (AACE) suggests shooting for a 140 mg/dl blood sugar by 2 hours after eating, and better if you can get it, which Type 2s on diet can do if they cut back on starch and sugar.
I set a new record for my fasting this morning: 83! Now, lets see if I can have a perfect day, or two, or many!
You are exactly right Jenny!
I’ve never had insurance since I’ve been dx’d, and always felt I should be testing before and after EACH meal, as well as upon rising and before bed) so that I could learn how different foods affected my BG. Once I got that all down, I slacked off of the testing, uless I ate something new or just wasn’t feeling “right”.
Once on insulin, I upped my testing again - 8 to 12 times a day. Essential when one begins taking insulin anyway. Again, a learning experience. How the insulin affected me, as well as how foods affected me with taking the insulin. I’ve again slacked off on that, and test usually 4 to 6 times a day. Sometimes less. I now know pretty well how the insulin works with my body, and how I “feel”, I pretty much know if I’m in good range or not. Sometimes I am off tho! I do know to test more often, when I’ve decided to eating something loaded with carbs, especially if I’m having to “guestimate” how many carbs are in that meal (usually restraunt eating), therefore guestimating how much insulin to take.
Anywho … I’ve had to endure the ACTUAL cost of test strips, which is NOT cheap by any means!! But thankfully there is eBay, where I can get them at about 1/2 price of purchasing them at the pharmacies!
I still feel, that even if one DOES have insurance, and they (ins. company) don’t allow you the amount of test strips you ACTUALLY need, then purchase more with your own money! Yes, it’s expensive, but it is also VERY worth it! You’ll have a MUCH better idea of what your BG’s REALLY are, than with only 2 tests per day!
I take 4u for 40g carbs (1:10 ratio). I too, don’t think this is a huge amount, especially if I’m “supposed” to have insulin resistance. I do take metformin (1000mg 2x daily) as well, but doc never mentioned it was for IR, but that it was to help with the weight gain that insulin often causes (so much for that anyway! LOL). Which is why I’m wondering if I’m not actually T1.5 instead of T2!? Have to have the tests (C-Peptide & GAD) done to know this for sure though, and plan on it as soon as I can afford it or I have insurance.
I know of some T1’s that take Metformin, to help with insulin resitance too. If it helps their control, I’d say that would probably depend upon if they have insulin resistance or not. shrugs
Melissa, a 1:10 ratio is not typical for an insulin resistant Type 2, even on metformin. I was just reading a message posted by a guy who reports using 70 units of novolog at each meal. THAT’s insulin resistant! (And that was with 100 units of basal insulin too.)
There are so many more of us out there who are diagnosed as insulin resistant type 2s because we are middle aged and may have packed on some weight after our bgs got very high. Or just because we’re older.
My ratio is about 1/15 with 1500 mg of Metformin. I’m off the Met for a while right now, and my ratio has dropped a bit–but it’s still close to 1/10.
Metformin not only counters insulin resistance, I believe it also shuts off glucose production by the liver when insulin levels are low, which is another thing that raises blood sugar. I suspect that is what it is doing for me–which is why my bgs go up when I stop it. But since most type 2s are using anywhere from 2 to 10 times as much insulin as I am, I figure I’m probably not IR to the extent that it would mean much.
I also started by checking 6-8 times a day now I only check 2 times a day usually breakfast. unless I have a high then I check before and after each meal until I get back on track. also if I eat something new. I want to buy extra test strips so I can check more often and not worry about running out.
I agree with you Jenny! BTW I packed on my weight LONG before I was dx’d! That started while pregnant with the first kid! LOL 50 pounds I gained with him!! I went from 105 to 155!! GASP (and I was only 18 too!!) Only got worse from then on out! Apparently having children significantly changed my metabolism! I was MORE active AFTER I had kids than before I had them!! As well as I had TWO boys, 12 months and 2 weeks apart!! Rest, Relaxation, Lazy, Kick Back … WHAT’S THAT??? Those words were NOT in my vocabulary or my life for YEARS! LOL
100u of Basal, 70u of basal! O.M.G. faints LOL Holy Bajeezes!
With that family history, you may very well have one of the genetic forms of diabetes that isn’t autoimmune.
I also gained 50 lbs with each child and became diabetic immediately after getting pregnant. I weighed 117 when I started the pregnancy (which for me is thin, as I’m built big.) I got back down to 130, had a second kid, gained 50 lbs, and got back to 135 and stayed there for the next decades until my bgs went way out of control and I suddenly packed on 30 lbs in one year. (I got it off, thank goodness, with a very low carb diet.)
I have read that MODY is often first identified during pregnancy when a normal weight person gets GD. And it is often mistaken for both Type 1 and Type 2, because the same gene can express very strongly or weakly. Your family history and personal history are VERY suggestive for it.
It’s expensive to test for it, but one way of doing a quick and dirty diagnosis, which you can check out with your doctor if you are interested, is that if you have one of the more common forms, a tiny dose of Amaryl will drop your blood sugar hugely. I took 1/8 of 1 mg of Amaryl (usual starting dose is 2 mg) and was eating carbs all day to stay in the 90s .
So for some people with that kind of genetic diabetes, tiny doses of Amaryl of Glipizide are an alternative to insulin. For me, it was a bit too much, plus the Amaryl made me ravenously hungry. Other people with that kind of diabetes get very good results from Byetta, but it is very expensive.
Anyway, it’s something to keep in mind. And you should keep your eye out for a study where they are looking for people with that kind of family history, because some of them will give you all sorts of expensive tests for free. Joslin was doing one a while back, but I didn’t have enough living family members to qualify for it.
Ugh! My numbers had been running great and then the past few weeks I’ve been all over the place, both highs and lows for no explainable reason. Of course, this is the way it works since I have an appointment with my Endo on Thursday!
So how did it go Jolie?? Did you keep the “perfect” day?? I hope so, and I hope it continues!! :0)
Definitely have a family history of the D! NO doubts there! I didn’t have GD with my first two pregnacies. And with each successive pregnancy, I gained less. First 50 as stated, second 40, with no time to really lose any wieght in between, since I got pregnant 2-1/2 months after the first was born, I was also breastfeeding, and just as my milk dried up (that’s a whole 'nother long story there) I got pregnant again. Then with my last, I was dx’d with GD and I only gained 25 pounds with that one. Had two factors for the “good” amount of weight gain, I was SICK from the time I was about 3 months pregnant, EACH AND EVERY DAY, MULTIPLE TIMES a day, for an entire 7 months (she was 3 weeks late - yet another story there too! LOL) Then add in the “GD Diet” I was on. This was just over 20 years ago, no meds or insulin given when preggers with GD in those days! LOL.
I’ve never taken Amaryl, but have been on Glipizide from the day I was Dx’d T2 until Feb 11th of this year (about 18 months) It worked for about a year pretty decently along with the metformin. Then it wasn’t working anymore. Which is why I’m on insulin now.
We’re SUPPOSED to be getting insurance here shortly according to the bosses wife!! Hubby’s been on them like flies on you know what, lately about that! They say they’re waiting on “them” (who ever is dealing with the insurance companies??) I said, well she needs to light a fire under somebody’s butt then!! LOL Hopefully it will be SOON, and my Endo is on their “list” and I can get these tests done sooner, than if I had to pay for it myself!
My numbers used to be regular like those, but lately they have gone completely crazy. I am trying to adjust to shots after four years on the pump, and think the west coast heat wave might have something to do with it…but they are still driving me nuts.
Does anybody have trouble keeping up with work after a series of prolonged highs? If so, how do you deal with it?
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It was a perfect day for me Melissa, Thanks!
After Breakfast: 125
Before Lunch: 105
After Lunch: 94
Before Dinner: 124 (and after exercise…my numbers always rise after exercise)
After Dinner: 130
And…I only had to shoot 7u NovalinR to cover the carbs at dinner. And, even better…my fasting this morning was 94. Usually, if I have a perfect day, the next day my fasting is high. But not today!
Well, if you have tried the glipizide, you can probably rule out the known MODYs, though it is possible that you have another, still not discovered, genetic form of diabetes.
When I spoke with the study recruiter at Joslin about MODY she told me that they think there may be dozens if not hundreds of other genes out there that cause these non-insulin resistant forms of diabetes that run in families. They were looking to find new ones.
I went through EXACTLY the same thing with the throwing up. The doctor who told me I had GD told me that my continual throwing up was controlling my blood sugar very well! This was 21 years ago, and you’re right, no meter, no insulin, no mention that carbs raise blood sugar, or even WHY I’d want to keep blood sugar normal. Nothing. And HUGE babies, right? Both mine were 9 lbs.
The first meter I saw was in the delivery suite for my second, when they had me on a pitocin pump. I had no idea what it was. They didn’t have the automated lancets, either. The nurse just came at me with a lancet needle and jabbed! When I learned later what the risks were of an uncontrolled diabetic pregnancy, it really freaked me out.
And even worse, with MODY, uncontrolled blood sugars in the mom can make the bad gene express worse for the kids if they have that gene. My daughter has impaired bgs at age 24 despite being fit enough to be a model and bicycling hundreds of miles a week (she doesn’t own a car.) So I feel bad about that. My dad was the carrier and my mom still has normal bg even at age 91, so mine was milder to start with.
Glad you are getting insurance! I have insurance that pays for my stuff, but I’m self employed so I actually pay MORE each month in premiums than I ever would spend on drugs or doctors and that is with 200 strips a month, too. I’m paying a lot more for my insurance than I paid for rent around the time my first kid was born.
Those are great numbers. If you can keep your 2 hour PP under 140 consistently you’ll end up with that 5% A1c. Under 120 consistently will usually give under 5.5%.
Are you using a basal, or only the R? Your numbers look a lot like mine on R, though I find if I have even a smigin too much R at dinner I may sometimes go low at 3:AM and then my body goes into freakout mode and I wake up at 108 since it raised the blood sugar too much.
Jenny, I am going to admit here (in spite of being diabetic for almost 5 years) that I have no idea what basal means. If it means other insulin over and above the R, then I use 30u Lantus at night and I am also on Byetta. My other diabetic meds include 2000mg Metformin and 20mg Glipizide daily. My immediate goal is to lose the glipizide. I thought that after getting on the Byetta, that would happen fairly quickly, but so far it is slow going. The doc thought that I would experience some lows and so far I have not.
I’ve often wondered if I was going low in the night and my body tried to over-correct on which would seem to explain why I was always so high in the morning. Since I’ve starting using the Lantus, my a.m. fasting numbers have definitely improved.
Lantus is, indeed, a “basal” insulin. Our bodies, when normal, secrete two different ways. The “Basal” secretion pulses out small amounts of insulin steadily throughout the day every couple minutes. “Phase one” insulin is secreted by beta cells only when blood sugar levels rise and meets food within 1/2 hour. “Phase two” insulin is secreted after blood sugars rise if the phase one isn’t enough.
Lantus is an artificial basal insulin. The R is an artificial Phase Two. Unfortunately, there is no insulin available now that mimics the speed of Phase one response which gets right into the blood stream as soon as you have a bite or so.
Byetta duplicates the beta cell stimulation of glipizide, the difference is, that with Byetta no stimulus occurs until blood sugars rise over a blood sugar threshold (probably 120 mg/dl.) But with glipizide you are always secreting insulin until the drug is out of your system. This is why it is believed it may burn out beta cells.
If you aren’t going low, it is possible your poor beat up beta cells aren’t capable of any more secretion in response to stimulation by any drug.
A lot of doctors REALLY do not understand how GLP-1 works to control blood sugar. I checked this out with some distinguished researchers who explained that incretin drugs work on the same pathways in the beta cells as do the Sulf drugs like Glipizide and Amaryl. What is different is that they only stimulate secretion after blood sugars rise.
The other thing GLP-1 does is slow stomach emptying and change how your brain responds to hunger signals, which sulfs don’t do. That seems to be why it is so helpful to some people for weight loss. But sulfs, in my experience CAUSE hunger signals.
With insulin and byetta , you may not need the glipizide at all. Have you ever stopped taking it for a few days to see what the difference would be in your blood sugars. If you don’t see a difference, you may not need it. And since you are supplementing with insulin you can make minor adjustments if needed.
That is what my endo tells me to do if I have questions about a drug–stop it for a week and see what happens.